Transportation assistance

[Imrazor]

My fiancee is dialyzing in town about 5 miles away. However she cannot drive and her eyes are shot, so I have to drive her. Currently, I'm unemployed so that's not an immediate problem. Once I get a job, though, we'll have no choice but to pay a cab to take her to dialysis. That's $20 each way, three times a week. On my old job, that wasn't a problem since I started work at 1pm. If I get a "normal" 8 to 5 job we're going to have a problem. If I'm lucky I'll be able to drop her off before work, but she'll still have to get a cab home.

The next county over has transportation for the disabled, but of course ours does not - unless you live with .75 miles of a bus stop or some nonsense. The closest bus stop is probably 12 miles away since we're (sort of) in the country. Moving's not really an option since I own my house, and it's in poor shape for the real estate market.

So how do the rest of you afford transportation for dialysis?

[nursey66]

Some places have volunteer drivers , usually older retired folks just looking for something to do, my aunt and uncle did it for years,, taking people to Dr Apps dialysis etc. Check with your county to see if that is available in your area.

[Michael Murphy]

Speak with the clinics Social Worker it's their job to help with these options, ask other patients if they have any sugrstions. 

[Charlie B53]

When I was the Handicapped Crew Supv at a local freeway rest area I talked to a few medical appt drivers, some were private company contracted by either Medicare or Medicade to ferry patients to appts.  Your Social Worker should be able to check this out and seee what is available in your area.

[Simon Dog]

I walk upstairs to the spare bedroom.

Since you are marrying her/him, it is an option you may want  to consider.

[smartcookie]

Definitely speak with the social worker.  If he/she does not have any advice, call 211.  It is a resource line that the United Way runs, kind of like dialing 411 for directory assistance.  They can let you know what is in the area. 

[Rerun]

Uber is cheaper if it is available in your town.  I took a cab to the eye doctor and it was $14 and on the way home I took Uber and it was $7.

It is a problem for those of us who do't drive anymore.  Right now Tom has volunteered to take me because we are on the same shift.  I get him a gift card about once a month to Jack in the Box.... his favorite place to eat.

[Imrazor]

Uber is iffy in my town, particularly during off-peak hours. At 6:45 am in the morning there just aren't any drivers available.

I'll try calling 211 and see if United Way can help.

The social worker at the local clinic hasn't been very helpful. Though the clinic is only a couple of miles away, it's technically in a different county and I think she's just used to assisting those from the other county.

Don't get me started on marriage. We sat down and looked at the tax code and the benefit rules and how marriage would impact our financial situation. We figured that marriage would cost my fiancee $300 - $400 a month in lost benefits and increased taxes. That's bankruptcy territory. So no marriage for now.

[Simon Dog]

So no marriage for now.

The clinics do not require that you be married to a care partner for home dialysis.

But, if you skip marriage, it's important to get a decent attorney to draw up power of attorney; medical proxies; wills and to set up your assets so they will pass outside of probate.   For example, this would happen pretty much automatically with your house if married; if not you need to set up a trust and have the beneficiaries of the trust set up to effect the same thing.

Also, remember, optimal spousal social security benefits require 10+ years of marriage.

[smartcookie]

For finances you definitely need an attorney.  For Health Care Power of Attorney, you can do the Five Wishes instead.  It is a living will and power of attorney in one, and you don't need an expensive lawyer.  All you need is two unrelated witness who are not part of your healthcare team and a notary.  It is legally binding in 42 states and most countries.  https://www.agingwithdignity.org/five-wishes/about-five-wishes

[Charlie B53]

........ We sat down and looked at the tax code and the benefit rules and how marriage would impact our financial situation. We figured that marriage would cost my fiancee $300 - $400 a month in lost benefits and increased taxes. That's bankruptcy territory. So no marriage for now.

Smart move.    I've told others this same thing, you have to look at all the things to make a better informed decision like this.

Simon and Smart Cookie also have very good points that need to be considered as well.

[Imrazor]

So I've dug a bit more into the transportation issue. It seems that there is an on-demand bus service for rural residents in my county that charges $4 per trip. BUT they may not allow riders to catch a ride into another county. Looking at the county maps it seems that my fiancee's dialysis clinic is less than one mile over the border. I'll call tomorrow morning and see if getting a ride to the clinic is possible. On a positive note, her nephrologist's and surgeon's offices ARE within the county line, so the bus service may at least take care of doctor's visits.

It may be necessary for her to change dialysis clinics even though this one is the closest. She's not fond of it, but at this point any change could be overwhelming for her. At least if she switches to another clinic, I think she can keep her current doctors.

I will also call 211 tomorrow and see if United Way can help at all.

I know Medicaid will pay for transportation, but my fiancee only has 'partial' Medicaid coverage. Medicaid pays her Medicare premiums, but I'm not sure if that would qualify her for transporation assistance.

As luck would have it, my state does not allow Five Wishes. Score another victory for the Alabama Bar Association.

[Michael Murphy]

One last thing to try, go to dialysis talk to other patients see if anyone is coming from your neck of the woods, you may be able get a lift in with them.
The other thing to look up is there a group that provides rides for the blind or disabled. At my other house in the boondocks one of the churches drives the disabled to medical appointments.

[Imrazor]

@Michael Murphy - Totally off-topic, but is that Tux the Penguin I see for your profile photo? Linux fan?

[Michael Murphy]

I spent 35 years as a UNIX system programmer, I spent 24 years at AT&T, 4 years at NYC ACS, And 4 years at the Federal Reserve.  Some where along the way I became a LINUX admin.  I worked on all types of systems from minis to mainframe.  It was fun .

[smartcookie]

It sounds like your fiancé has LIS, a low income subsidy.  That means that Medicaid pays for her Medicare premium and that her medicines are charged at a Medicaid rate, but she does not have Medicaid health insurance.  Unfortunately, that means she cannot get transportation through Medicaid. 

[Imrazor]

@smartcookie That sounds right. She is considered QI-1, which means Medicaid pays for her Medicare Part B (or is it Part D?) premium. She also gets SSDI, with no SSI. Thanks for the confirmation, even if it is bad news.